National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
AHRQ Research Studies Date
Topics
- Adverse Events (2)
- Arthritis (1)
- Blood Clots (1)
- Cancer (8)
- (-) Cancer: Breast Cancer (24)
- Cancer: Colorectal Cancer (1)
- Cancer: Prostate Cancer (1)
- Cardiovascular Conditions (1)
- Case Study (1)
- Children/Adolescents (1)
- Chronic Conditions (1)
- Clinician-Patient Communication (1)
- Communication (1)
- Comparative Effectiveness (2)
- Cultural Competence (1)
- Decision Making (3)
- Diagnostic Safety and Quality (2)
- Digestive Disease and Health (1)
- Disparities (3)
- Elderly (1)
- Evidence-Based Practice (1)
- Genetics (2)
- Guidelines (1)
- Healthcare Costs (1)
- Healthcare Delivery (2)
- Health Status (1)
- Imaging (3)
- Injuries and Wounds (1)
- Lifestyle Changes (1)
- Low-Income (1)
- Medication (3)
- Men's Health (1)
- Mortality (1)
- Obesity (1)
- Outcomes (1)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (5)
- Patient and Family Engagement (1)
- Patient Self-Management (1)
- Prevention (2)
- Provider Performance (1)
- Racial and Ethnic Minorities (7)
- Research Methodologies (1)
- Risk (3)
- Screening (6)
- Social Determinants of Health (1)
- Stroke (1)
- Surgery (1)
- Telehealth (1)
- Treatments (4)
- U.S. Preventive Services Task Force (USPSTF) (1)
- Women (7)
- Young Adults (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 24 of 24 Research Studies DisplayedPruitt SL, Tiro JA, Xuan L
Hispanic and immigrant paradoxes in U.S. breast cancer mortality: impact of neighborhood poverty and Hispanic density.
The researchers tested the Hispanic and Immigrant Paradoxes-i.e., survival advantages despite a worse risk factor profile-and the modifying role of neighborhood context. They found no evidence of an Immigrant Paradox and some evidence of a Hispanic Paradox where protective effects were limited to U.S.-born Hispanics. Contrary to prior studies, foreign birthplace and residence in higher Hispanic density neighborhoods were associated with increased mortality.
AHRQ-funded; HS022418.
Citation: Pruitt SL, Tiro JA, Xuan L .
Hispanic and immigrant paradoxes in U.S. breast cancer mortality: impact of neighborhood poverty and Hispanic density.
Int J Environ Res Public Health 2016 Dec 14;13(12):E1238. doi: 10.3390/ijerph13121238.
.
.
Keywords: Cancer: Breast Cancer, Low-Income, Racial and Ethnic Minorities, Mortality, Racial and Ethnic Minorities
Giordano SH, Niu J, Chavez-MacGregor M
Estimating regimen-specific costs of chemotherapy for breast cancer: observational cohort study.
The objective of the current study was to generate cost estimates for guideline-concordant adjuvant chemotherapy regimens from payers' and patients' perspectives in a large, insured US population. It concluded that the costs of breast cancer chemotherapy vary widely across regimens, and patients bear a substantial out-of-pocket burden.
AHRQ-funded; HS020263.
Citation: Giordano SH, Niu J, Chavez-MacGregor M .
Estimating regimen-specific costs of chemotherapy for breast cancer: observational cohort study.
Cancer 2016 Nov 15; 122(2):3447-3455. doi: 10.1002/cncr.30274.
.
.
Keywords: Cancer, Cancer: Breast Cancer, Treatments, Healthcare Costs
Elmore JG, Cook AJ, Bogart A
Radiologists' interpretive skills in screening vs. diagnostic mammography: are they related?
This study aimed to determine whether radiologists who perform well in screening also perform well in interpreting diagnostic mammography. It evaluated the accuracy of 468 radiologists interpreting 2,234,947 screening and 196,164 diagnostic mammograms and found a moderate correlation for radiologists' accuracy when interpreting screening versus their accuracy on diagnostic examinations.
AHRQ-funded; HS010591.
Citation: Elmore JG, Cook AJ, Bogart A .
Radiologists' interpretive skills in screening vs. diagnostic mammography: are they related?
Clin Imaging 2016 Nov - Dec;40(6):1096-103. doi: 10.1016/j.clinimag.2016.06.014.
.
.
Keywords: Cancer: Breast Cancer, Diagnostic Safety and Quality, Screening, Imaging, Women, Provider Performance
Goodwin JS, Sheffield K, Li S
Receipt of cancer screening is a predictor of life expectancy.
The researchers sought to determine the association between receipt of screening mammography or PSA and overall survival. They found that the subjects with prior cancer screening had actual median survivals higher than those who were not screened, with differences ranging from 1.7 to 2.1 years for women and 0.9 to 1.1 years for men.
AHRQ-funded; HS022134.
Citation: Goodwin JS, Sheffield K, Li S .
Receipt of cancer screening is a predictor of life expectancy.
J Gen Intern Med 2016 Nov;31(11):1308-14. doi: 10.1007/s11606-016-3787-y.
.
.
Keywords: Cancer, Cancer: Breast Cancer, Cancer: Prostate Cancer, Screening, Women, Men's Health, Health Status
Scarinci IC, Garces-Palacio IC, Morales-Aleman MM
Sowing the seeds of health: training of community health advisors to promote breast and cervical cancer screening among Latina immigrants in Alabama.
The researchers sought to develop and evaluate a culturally relevant training for Community Health Advisors (CHA) to promote breast and cervical cancer screening among Latina immigrants in Alabama. They found that a knowledge and skills training increased the CHAs' (1) knowledge of cancer screening and other health topics and (2) their perceived confidence to communicate with women in their communities about cancer screening and to motivate them to attain screenings.
AHRQ-funded; HS013852.
Citation: Scarinci IC, Garces-Palacio IC, Morales-Aleman MM .
Sowing the seeds of health: training of community health advisors to promote breast and cervical cancer screening among Latina immigrants in Alabama.
J Health Care Poor Underserved 2016;27(4):1779-93. doi: 10.1353/hpu.2016.0162.
.
.
Keywords: Cancer, Cancer: Breast Cancer, Racial and Ethnic Minorities, Screening, Women
Mamtani R, Clark AS, Scott FI
Association between breast cancer recurrence and immunosuppression in rheumatoid arthritis and inflammatory bowel disease: a cohort study.
The researchers examined the rates of breast cancer recurrence in patients with immune-mediated disease and treated breast cancer who received therapy with methotrexate, thiopurines, or anti-tumor necrosis factor (anti-TNF). They found that the risk of breast cancer recurrence in patients who received methotrexate, thiopurine, or anti-TNF therapy was not statistically significantly increased, although they did not rule out a 2-fold or greater increased risk in those treated with thiopurines.
AHRQ-funded; HS021110; HS018517.
Citation: Mamtani R, Clark AS, Scott FI .
Association between breast cancer recurrence and immunosuppression in rheumatoid arthritis and inflammatory bowel disease: a cohort study.
Arthritis Rheumatol 2016 Oct;68(10):2403-11. doi: 10.1002/art.39738.
.
.
Keywords: Cancer: Breast Cancer, Digestive Disease and Health, Medication, Patient-Centered Outcomes Research, Arthritis
Croswell J, Owings J
Screening for breast cancer.
This case study involves a 47-year-old woman who presents to your office for a well-woman visit. She is healthy, takes no medications, and has no health concerns. She has never been diagnosed with breast cancer, nor have any of her first-degree relatives. Her digital mammography two years ago was negative, and she asks whether she should be screened again this year. The study poses three multiple choice questions together with the U.S. Preventive Services Task Force recommendations and related background information.
AHRQ-authored.
Citation: Croswell J, Owings J .
Screening for breast cancer.
Am Fam Physician 2016 Jul 15;94(2):143-4.
.
.
Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Breast Cancer, Cancer, Screening, Prevention, Evidence-Based Practice, Women, Imaging, Case Study
Bertrand KA, Baer HJ, Orav EJ
Early life body fatness, serum anti-mullerian hormone, and breast density in young adult women.
Researchers examined associations of early life body fatness, serum anti-Mullerian hormone (AMH) concentrations, and breast density among 172 women in the Dietary Intervention Study in Children (DISC). They found no evidence that current or early life BMI influences AMH concentrations in later life. Women with higher concentrations of AMH had similar percent and absolute dense breast volume, but lower nondense volume.
AHRQ-funded; HS019789.
Citation: Bertrand KA, Baer HJ, Orav EJ .
Early life body fatness, serum anti-mullerian hormone, and breast density in young adult women.
Cancer Epidemiol Biomarkers Prev 2016 Jul;25(7):1151-7. doi: 10.1158/1055-9965.epi-16-0185.
.
.
Keywords: Cancer: Breast Cancer, Children/Adolescents, Obesity, Women, Young Adults
Ridner SH, Rhoten BA, Radina ME
Breast cancer survivors' perspectives of critical lymphedema self-care support needs.
The purpose of this paper was to solicit breast cancer survivors' perspectives on the variety of issues they face related to lymphedema self-care and to identify support needs perceived as critical for managing their chronic medical condition. The authors found that lack of support and the failure of others to recognize lymphedema as a chronic condition set this patient population apart from other patients with chronic diseases and decreases the amount of help needed to manage the condition.
AHRQ-funded; HS022990.
Citation: Ridner SH, Rhoten BA, Radina ME .
Breast cancer survivors' perspectives of critical lymphedema self-care support needs.
Support Care Cancer 2016 Jun;24(6):2743-50. doi: 10.1007/s00520-016-3089-2.
.
.
Keywords: Cancer: Breast Cancer, Chronic Conditions, Patient-Centered Outcomes Research, Patient Self-Management
Roberts MC, Bryson A, Weinberger M
Patient-centered communication for discussing oncotype DX testing.
The researchers identified patient-centered communication strategies/gaps for discussing Oncotype DX testing (ODX) results. They applied a patient-centered communication framework to analyze qualitative interviews with oncologists about how they communicate about ODX with patients. Overall, providers discussed four patient-centered communication domains: exchanging information, assessing uncertainty, making decisions and cross-cutting themes.
AHRQ-funded; HS019468; HS022189.
Citation: Roberts MC, Bryson A, Weinberger M .
Patient-centered communication for discussing oncotype DX testing.
Cancer Invest 2016 May 27;34(5):205-12. doi: 10.3109/07357907.2016.1172637.
.
.
Keywords: Cancer, Cancer: Breast Cancer, Communication, Clinician-Patient Communication, Decision Making, Genetics, Patient and Family Engagement, Patient-Centered Healthcare, Women
Du XL, Zhang Y, Hardy D
Associations between hematopoietic growth factors and risks of venous thromboembolism, stroke, ischemic heart disease and myelodysplastic syndrome: findings from a large population-based cohort of women with breast cancer.
The researchers sought to determine the risk of venous thromboembolism (VTE), stroke, ischemic heart disease, and myelodysplastic syndrome (MDS) in association with the receipt of colony-stimulating factors (CSFs) and/or erythropoiesis-stimulating agents (ESAs) in women with breast cancer. They found that receipts of CSFs and ESAs were significantly associated with an increased risk of VTE in women with breast cancer.
AHRQ-funded; HS018956.
Citation: Du XL, Zhang Y, Hardy D .
Associations between hematopoietic growth factors and risks of venous thromboembolism, stroke, ischemic heart disease and myelodysplastic syndrome: findings from a large population-based cohort of women with breast cancer.
Cancer Causes Control 2016 May;27(5):695-707. doi: 10.1007/s10552-016-0742-5.
.
.
Keywords: Blood Clots, Cancer: Breast Cancer, Cardiovascular Conditions, Risk, Stroke
Nickel KB, Fox IK, Margenthaler JA
Effect of noninfectious wound complications after mastectomy on subsequent surgical procedures and early implant loss.
The authors determined the rates of noninfectious wound complications (NIWCs) among women undergoing mastectomy and assessed the impact of immediate reconstruction (IR). They found that the rate of NIWC was approximately 2-fold higher after mastectomy with IR than after mastectomy only and that noninfectious wound complications were associated with additional surgical treatment, particularly in women with implant reconstruction, and with early implant loss.
AHRQ-funded; HS019455.
Citation: Nickel KB, Fox IK, Margenthaler JA .
Effect of noninfectious wound complications after mastectomy on subsequent surgical procedures and early implant loss.
J Am Coll Surg 2016 May;222(5):844-52.e1. doi: 10.1016/j.jamcollsurg.2016.01.050.
.
.
Keywords: Adverse Events, Cancer: Breast Cancer, Injuries and Wounds, Surgery
Liu Z, Zhang K, Du XL
Risks of developing breast and colorectal cancer in association with incomes and geographic locations in Texas: a retrospective cohort study.
This study aimed to determine whether median household income was associated with the risk of developing breast and colorectal cancer in Texas and to identify higher cancer risks by race/ethnicity and geographic areas. It demonstrated that higher income was associated with an increased risk of breast cancer and a decreased risk of colorectal cancer in Texas.
AHRQ-funded; HS018956.
Citation: Liu Z, Zhang K, Du XL .
Risks of developing breast and colorectal cancer in association with incomes and geographic locations in Texas: a retrospective cohort study.
BMC Cancer 2016 Apr 26;16:294. doi: 10.1186/s12885-016-2324-z.
.
.
Keywords: Cancer: Breast Cancer, Cancer: Colorectal Cancer, Racial and Ethnic Minorities, Risk, Social Determinants of Health
Lyons EJ, Baranowski T, Basen-Engquist KM
Testing the effects of narrative and play on physical activity among breast cancer survivors using mobile apps: study protocol for a randomized controlled trial.
This paper described a study to determine the effectiveness of an intervention that combines narrative and gaming to encourage sustained physical activity in postmenopausal breast cancer survivors. The primary outcome of the study is minutes of moderate to vigorous physical activity at six months. Other objectively measured outcomes include fitness and physical function. Self-reported outcomes include quality of life, depression, and motivation.
AHRQ-funded; HS022134.
Citation: Lyons EJ, Baranowski T, Basen-Engquist KM .
Testing the effects of narrative and play on physical activity among breast cancer survivors using mobile apps: study protocol for a randomized controlled trial.
BMC Cancer 2016 Mar 9;16:202. doi: 10.1186/s12885-016-2244-y.
.
.
Keywords: Cancer: Breast Cancer, Comparative Effectiveness, Lifestyle Changes, Patient-Centered Outcomes Research, Telehealth
Du XL, Zhang Y, Hardy D
Temporal and geographic variations in the receipt of colony-stimulating factors and Erythropoiesis-stimulating agents in a large retrospective cohort of older women with breast cancer from 2000 to 2009.
The purpose of this study was to use the most recent national data for a large cohort of patients diagnosed with breast cancer to evaluate temporal trend of receiving hematopoietic growth factors and to examine significant factors associated with increasing trends and geographic variations. The receipt of colony-stimulationg factors continued to increase throughout the study period, and pegfilgrastim started to replace filgrastim since 2003. The receipt of erythropoiesis-stimulating agents increased at first, then declined substantially due to the black box warning. There were substantial geographic variations in the use of these hematopoietic growth factors.
AHRQ-funded; HS018956.
Citation: Du XL, Zhang Y, Hardy D .
Temporal and geographic variations in the receipt of colony-stimulating factors and Erythropoiesis-stimulating agents in a large retrospective cohort of older women with breast cancer from 2000 to 2009.
Am J Ther 2016 Mar-Apr;23(2):e411-21. doi: 10.1097/mjt.0000000000000182.
.
.
Keywords: Cancer: Breast Cancer, Medication, Elderly
Nelson HD, O'Meara ES, Kerlikowske K
Factors associated with rates of false-positive and false-negative results from digital mammography screening: an analysis of registry data.
The researchers sought to determine factors associated with false-positive and false-negative digital mammography results, additional imaging, and biopsies among a general population of women screened for breast cancer. They found that false-positive mammography results and additional imaging are common, particularly for younger women and those with risk factors, whereas biopsies occur less often. Rates of false-negative results are low.
AHRQ-funded; 290201200015I.
Citation: Nelson HD, O'Meara ES, Kerlikowske K .
Factors associated with rates of false-positive and false-negative results from digital mammography screening: an analysis of registry data.
Ann Intern Med 2016 Feb 16;164(4):226-35. doi: 10.7326/m15-0971.
.
.
Keywords: Cancer: Breast Cancer, Cancer, Imaging, Diagnostic Safety and Quality, Women, Screening, Prevention
Farias AJ, Du XL
Ethnic differences in initiation and timing of adjuvant endocrine therapy among older women with hormone receptor-positive breast cancer enrolled in Medicare Part D.
The aim of this study was to determine whether there are racial/ethnic differences in initiation and timing of adjuvant endocrine therapy (AET) after Medicare Part D drug coverage. After controlling for all variables, only Asian women were found to have a greater odds of initiation of overall AET compared to non-Hispanic white women. Hispanic Mexicans and non-Hispanic black patients had a significantly lower odds of tamoxifen initiation.
AHRQ-funded; HS018956.
Citation: Farias AJ, Du XL .
Ethnic differences in initiation and timing of adjuvant endocrine therapy among older women with hormone receptor-positive breast cancer enrolled in Medicare Part D.
Med Oncol 2016 Feb;33(2):19. doi: 10.1007/s12032-016-0732-1.
.
.
Keywords: Cancer: Breast Cancer, Treatments, Patient-Centered Outcomes Research, Racial and Ethnic Minorities
Roberts MC, Weinberger M, Dusetzina SB
Racial variation in the uptake of oncotype DX testing for early-stage breast cancer.
Oncotype DX (ODX) has the potential to improve quality of care; however, if not equally accessible across racial groups, disparities in cancer care quality may persist or worsen. The researchers examined racial disparities in ODX testing uptake. They did not find racial disparities in ODX testing for node-negative patients for whom ODX testing is guideline recommended and widely covered by insurers.
HS019468; HS022189
Citation: Roberts MC, Weinberger M, Dusetzina SB .
Racial variation in the uptake of oncotype DX testing for early-stage breast cancer.
J Clin Oncol 2016 Jan 10;34(2):130-8. doi: 10.1200/jco.2015.63.2489..
Keywords: Cancer: Breast Cancer, Healthcare Delivery, Treatments, Disparities, Racial and Ethnic Minorities
Roberts MC, Bryson A, Weinberger M
Oncologists' barriers and facilitators for oncotype DX use: qualitative study.
The purpose of this paper was to understand better the U.S. oncologists' oncotype DX (ODX) uptake and how they use ODX during adjuvant chemotherapy decision making. This study identified multi-level factors that influence ODX uptake, including organizational factors, interpersonal factors, and intrapersonal factors.
AHRQ-funded; HS022189.
Citation: Roberts MC, Bryson A, Weinberger M .
Oncologists' barriers and facilitators for oncotype DX use: qualitative study.
Int J Technol Assess Health Care 2016 Jan;32(5):355-61. doi: 10.1017/s026646231600060x.
.
.
Keywords: Cancer: Breast Cancer, Treatments, Decision Making, Genetics, Medication
Frasier LL, Holden S, Holden T
Temporal trends in postmastectomy radiation therapy and breast reconstruction associated with changes in national comprehensive cancer network guidelines.
The researchers sought to determine whether revised guidelines have increased postmastectomy radiation therapy (PMRT) and affected receipt of breast reconstruction. They found that changes in NCCN guidelines have been associated with an increase in PMRT among patients with tumors 5 cm or smaller and 1 to 3 positive nodes without an associated decrease in receipt of reconstruction.
AHRQ-funded; HS022403.
Citation: Frasier LL, Holden S, Holden T .
Temporal trends in postmastectomy radiation therapy and breast reconstruction associated with changes in national comprehensive cancer network guidelines.
JAMA Oncol 2016 Jan;2(1):95-101. doi: 10.1001/jamaoncol.2015.3717.
.
.
Keywords: Cancer: Breast Cancer, Healthcare Delivery, Decision Making, Guidelines, Outcomes
Boothe DL, Coplowitz S, Greenwood E
Transforming growth factor beta-1 (TGF-beta1) is a serum biomarker of radiation induced fibrosis in patients treated with intracavitary accelerated partial breast irradiation: preliminary results of a prospective study.
This study examined a relationship between serum transforming growth factor b-1 (TGF-b1) values and radiation-induced fibrosis (RIF). The results suggest that serum TGF-b1 levels before surgery, and during radiation therapy, and after radiation therapy could signal whether a patient is at risk for the development of moderate to severe RIF.
AHRQ-funded; HS016075.
Citation: Boothe DL, Coplowitz S, Greenwood E .
Transforming growth factor beta-1 (TGF-beta1) is a serum biomarker of radiation induced fibrosis in patients treated with intracavitary accelerated partial breast irradiation: preliminary results of a prospective study.
Int J Radiat Oncol Biol Phys 2013 Dec 1;87(5):1030-6. doi: 10.1016/j.ijrobp.2013.08.045..
Keywords: Adverse Events, Cancer, Cancer: Breast Cancer, Risk
Percac-Lima S, Ashburner JM, Bond B
Decreasing disparities in breast cancer screening in refugee women using culturally tailored patient navigation.
The goal of this research was to evaluate whether a patient navigator (PN) program for refugee women decreases disparities in breast cancer screening. Results showed that linguistically and culturally tailored PN decreased disparities over time in breast cancer screening among female refugees from Somalia, the Middle East, and Bosnia.
AHRQ-funded; HS018161.
Citation: Percac-Lima S, Ashburner JM, Bond B .
Decreasing disparities in breast cancer screening in refugee women using culturally tailored patient navigation.
J Gen Intern Med 2013 Nov;28(11):1463-8. doi: 10.1007/s11606-013-2491-4.
.
.
Keywords: Cancer: Breast Cancer, Cultural Competence, Disparities, Racial and Ethnic Minorities, Screening
Nurgalieva ZZ, Franzini L, Morgan RO
Utilization of lymph node dissection, race/ethnicity, and breast cancer outcomes.
This study reports on the impact of nodal surgery utilization on survival among white, African American, Hispanic, and Asian women in a large population of women with breast cancer. It found that the disparities in survival among African American and Hispanic women with breast cancer are not explained by nodal surgery utilization among women with micrometastasis and macrometastasis in sentinel lymph nodes.
AHRQ-funded; HS018956.
Citation: Nurgalieva ZZ, Franzini L, Morgan RO .
Utilization of lymph node dissection, race/ethnicity, and breast cancer outcomes.
Am J Manag Care 2013 Oct;19(10):805-10..
Keywords: Cancer: Breast Cancer, Comparative Effectiveness, Disparities, Patient-Centered Outcomes Research, Racial and Ethnic Minorities
Boland MR, Miotto R, Gao J
Feasibility of feature-based indexing, clustering, and search of clinical trials. A case study of breast cancer trials from ClinicalTrials.gov.
Searching through a large collection of clinical trials using existing technology is a daunting task. This study extracted 1,437 eligibility features from 80 stage III breast cancer clinical trials and found that it is feasible to develop feature-based indexing and clustering methods for clinical trials to identify trials with similar target populations and to improve trial search efficiency.
AHRQ-funded; HS019853.
Citation: Boland MR, Miotto R, Gao J .
Feasibility of feature-based indexing, clustering, and search of clinical trials. A case study of breast cancer trials from ClinicalTrials.gov.
Methods Inf Med. 2013;52(5):382-94. doi: 10.3414/ME12-01-0092..
Keywords: Cancer: Breast Cancer, Cancer, Research Methodologies